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Bakker-van Gijssel EJ, Lucassen PLBJ, Olde Hartman TC, Assendelft WJJ, van Schrojenstein Lantman-de Valk HMJ. "Constructing a health assessment questionnaire for people with intellectual disabilities: A cognitive interview study". JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:345-353. [PMID: 31602729 DOI: 10.1111/jar.12676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Health assessment instruments can help to raise awareness among general practitioners of specific health problems in people with intellectual disabilities (PID). The present authors developed a health assessment questionnaire using the cognitive interview technique (CI) to improve the comprehensibility. The utility of this approach to questionnaire development involving PID is assessed. METHOD A qualitative approach using the CI was employed. The study included PID and their caregivers. The present authors interviewed 14 participants in 5 subsequent rounds. After each round, the questionnaire was adjusted until saturation was reached. RESULTS Three hundred and sixty three identified problems led to 316 changes to the questionnaire. Most problems (102) concerned the comprehension of the question, followed by problems in the "missing answer categories" and "inaccurate instruction" section. CONCLUSION The comprehensible health assessment questionnaire can help PID to take an active role in communication with their GP. The use of CI helped to improve the questionnaire. CI is a usable and valuable procedure for PID.
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Affiliation(s)
- Esther J Bakker-van Gijssel
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.,Siza, residential care facility for people with disabilities, Arnhem, The Netherlands
| | - Peter L B J Lucassen
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tim C Olde Hartman
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Willem J J Assendelft
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Bakker-van Gijssel EJ, Lucassen PLBJ, Olde Hartman TC, Assendelft WJJ, van Schrojenstein Lantman-de Valk HMJ. Development of a health assessment instrument for people with intellectual disabilities: a Delphi study. Fam Pract 2018; 35:599-606. [PMID: 29471438 DOI: 10.1093/fampra/cmy004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with intellectual disabilities (IDs) experience health inequalities. Applying health assessments is one way of diminishing these inequalities. A health assessment instrument can support general practitioners (GPs) in providing better medical care to people with ID. OBJECTIVES The aim of this study was to determine which items should be part of a health assessment instrument for people with ID to be used in primary care. METHODS This Delphi consensus study was conducted among 24 GP experts and 21 ID physicians. We performed three anonymous sequential online questionnaire rounds. We started with 82 'general' items and 14 items concerning physical and additional examinations derived from the international literature and a focus group study among Dutch GPs. We definitely included items if more than 75% of the GP experts agreed on their inclusion. RESULTS The participation rate in all rounds was above 88%. The expert groups proposed 10 new items. Consensus was reached on 64 'general' items related to highly prevalent diseases, public health and health promotion. Consensus was also reached on 18 physical and additional examination items. CONCLUSIONS For the first time, experts in a Delphi study were able to arrive at a selection of items for a health assessment instrument for people with ID. The overall agreement among the GPs and ID physicians was good. Because the experts prefer that patients complete the health assessment questionnaire at home, questions that cover these items must be formulated clearly.
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Affiliation(s)
- Esther J Bakker-van Gijssel
- Department of Primary and Community Care, Radboud University Medical Center, HB Nijmegen, The Netherlands.,Siza, Residential Care Facility for People with Disabilities, AM Arnhem, The Netherlands
| | - Peter L B J Lucassen
- Department of Primary and Community Care, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | - Tim C Olde Hartman
- Department of Primary and Community Care, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | - Willem J J Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, HB Nijmegen, The Netherlands
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Bakker-van Gijssel EJ, Lucassen PLBJ, Olde Hartman TC, van Son L, Assendelft WJJ, van Schrojenstein Lantman-de Valk HMJ. Health assessment instruments for people with intellectual disabilities-A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 64:12-24. [PMID: 28327382 DOI: 10.1016/j.ridd.2017.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/15/2017] [Accepted: 03/05/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems. AIM The aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality. METHODS We conducted an electronic literature search of papers published between January 2000 and May 2016. After a two-phase selection process (kappa: 0.81 and 0.77) we collected data from the 29 included peer-reviewed articles on the following four domains; development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content (i.e. ID-related health problems, prevention and health promotion topics) and effectiveness of the instruments. RESULTS/CONCLUSIONS We distinguished 20 different health assessment instruments. Limited information was found on the development of the instruments as well as on their clinimetric properties. The content of the instruments was rather diverse. The included papers agreed that health assessment instruments are effective. However, only three instruments evaluated effectiveness in a randomised controlled trial. Patients with ID, carers and general practitioners (GPs) generally appreciated the health assessment instruments. IMPLICATION Two instruments, "Stay well and healthy -Health risk appraisal (SWH-HRA)"and the "Comprehensive Health Assessment Programme (CHAP)", appeared to have the highest quality. These instruments can be used to construct a health assessment instrument for people with ID that meets scientific standards.
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Affiliation(s)
- E J Bakker-van Gijssel
- Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Siza, Residential Care Facility For People With Disabilities, PO Box 532, 6800 AM Arnhem, The Netherlands.
| | - P L B J Lucassen
- Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - T C Olde Hartman
- Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - L van Son
- Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - W J J Assendelft
- Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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GPs' opinions of health assessment instruments for people with intellectual disabilities: a qualitative study. Br J Gen Pract 2016; 67:e41-e48. [PMID: 27993898 DOI: 10.3399/bjgp16x688585] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/05/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND GPs provide health care to people with intellectual disabilities (ID). People with ID find it difficult to express themselves concerning health-related matters. Applying health assessments is an effective method to reveal health needs, and can play a role in prevention and health promotion. AIM The aim of this qualitative study was to explore GPs' considerations about applying a health assessment for people with ID. DESIGN AND SETTING This focus group study was conducted among a selection of Dutch GPs. METHOD An interview guide was developed. All discussions were audiorecorded and transcribed. Analysis was performed using the framework analysis approach. Two researchers independently applied open coding and identified a thematic framework. This framework and the summaries of views per theme were discussed in the research team. RESULTS After four focus groups, with 23 GPs, saturation was reached. Three main themes evolved: health assessments in relation to GPs' responsibility; the usefulness and necessity of health assessments; and barriers to using health assessments on people with ID. A health assessment instrument for people with ID can help GPs to focus on certain issues that are not so common in the general population. GPs are motivated to use such a tool if it is scientifically tested, and results in significant health gains. However, GPs identify barriers at the level of GP, patient, and organisation. CONCLUSION Most GPs in the focus groups consider providing medical care to people with ID their responsibility and indicate that a health assessment instrument could be a valuable tool. In order to deliver good care, they need education and support. Many barriers need to be overcome before a health assessment instrument can be implemented.
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Lennox N, McPherson L, Bain C, O'Callaghan M, Carrington S, Ware RS. A health advocacy intervention for adolescents with intellectual disability: a cluster randomized controlled trial. Dev Med Child Neurol 2016; 58:1265-1272. [PMID: 27343021 DOI: 10.1111/dmcn.13174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 11/28/2022]
Abstract
AIM Adolescents with intellectual disability experience poorer heath than their peers in the general population, partially due to communication barriers and knowledge gaps in their health history. This study aimed to test a health intervention package against usual care for a range of health promotion and disease detection outcomes. METHOD A parallel-group cluster randomized controlled trial was conducted with Australian adolescents with intellectual disability living in the community. Randomization occurred at school level. The intervention package consisted of classroom-based health education, a hand-held personalized health record, and a health check. Evidence of health promotion, disease prevention, and case-finding activities were extracted from general practitioners' records for 12 months post-intervention. RESULTS Clinical data was available for 435 of 592 (73.5%) participants from 85 schools. Adolescents allocated to receive the health intervention were more likely to have their vision (odds ratio [OR] 3.3; 95% confidence interval [CI] 1.8-6.1) and hearing (OR 2.7; 95% CI 1.0-7.3) tested, their blood pressure checked (OR 2.4; 95% CI 1.6-3.7), and weight recorded (OR 4.8; 95% CI 3.1-7.6). There was no difference between health intervention and usual care for identification of new diseases. INTERPRETATION The school-based intervention package increased healthcare activity in adolescents with intellectual disability living in the community.
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Affiliation(s)
- Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Qld, Australia
| | - Lyn McPherson
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Qld, Australia
| | - Chris Bain
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Michael O'Callaghan
- Paediatrics and Child Health, The University of Queensland, Brisbane, Qld, Australia
| | - Suzanne Carrington
- School of Learning & Professional Studies, Queensland University of Technology, Brisbane, Qld, Australia
| | - Robert S Ware
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Qld, Australia.,UQ Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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Shooshtari S, Temple B, Waldman C, Abraham S, Ouellette-Kuntz H, Lennox N. Stakeholders’ Perspectives towards the Use of the Comprehensive Health Assessment Program (CHAP) for Adults with Intellectual Disabilities in Manitoba. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:672-683. [DOI: 10.1111/jar.12261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Shahin Shooshtari
- Faculty of Health Sciences; Department of Community Health Sciences; St. Amant Research Centre; University of Manitoba; Winnipeg MB Canada
| | - Beverley Temple
- Faculty of Health Sciences; College of Nursing; St. Amant Research Centre; University of Manitoba; Winnipeg MB Canada
| | - Celeste Waldman
- Faculty of Health Sciences; College of Nursing; St. Amant Research Centre; University of Manitoba; Winnipeg MB Canada
| | - Sneha Abraham
- Faculty of Health Sciences; Department of Community Health Sciences; University of Manitoba; Winnipeg MB Canada
| | | | - Nicholas Lennox
- The Queensland Centre for Intellectual and Developmental Disability; School of Medicine; South Brisbane QLD Australia
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Balogh R, McMorris CA, Lunsky Y, Ouellette‐Kuntz H, Bourne L, Colantonio A, Gonçalves‐Bradley DC. Organising healthcare services for persons with an intellectual disability. Cochrane Database Syst Rev 2016; 4:CD007492. [PMID: 27065018 PMCID: PMC8720486 DOI: 10.1002/14651858.cd007492.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND When compared to the general population, persons with an intellectual disability have lower life expectancy, higher morbidity, and more difficulty finding and obtaining healthcare. Organisational interventions are used to reconfigure the structure or delivery of healthcare services. This is the first update of the original review. OBJECTIVES To assess the effects of organisational interventions of healthcare services for the mental and physical health problems of persons with an intellectual disability. SEARCH METHODS For this update we searched CENTRAL, MEDLINE, EMBASE, CINAHL and other databases, from April 2006 to 4 September 2015. We checked reference lists of included studies and consulted experts in the field. SELECTION CRITERIA Randomised controlled trials of organisational interventions of healthcare services aimed at improving care of mental and physical health problems of adult persons with an intellectual disability. DATA COLLECTION AND ANALYSIS We employed standard methodological procedures as outlined in the Cochrane Handbook of Systematic Reviews of Interventions, in addition to specific guidance from the Cochrane Effective Practice and Organisation of Care (EPOC) Group. MAIN RESULTS We identified one new trial from the updated searches.Seven trials (347 participants) met the selection criteria. The interventions varied but had common components: interventions that increased the intensity and frequency of service delivery (4 trials, 200 participants), community-based specialist behaviour therapy (1 trial, 63 participants), and outreach treatment (1 trial, 50 participants). Another trial compared two active arms (traditional counselling and integrated intervention for bereavement, 34 participants).The included studies investigated interventions dealing with the mental health problems of persons with an intellectual disability; none focused on physical health problems. Four studies assessed the effect of organisational interventions on behavioural problems for persons with an intellectual disability, three assessed care giver burden, and three assessed the costs associated with the interventions. None of the included studies reported data on the effect of organisational interventions on adverse events. Most studies were assessed as having low risk of bias.It is uncertain whether interventions that increase the frequency and intensity of delivery or outreach treatment decrease behavioural problems for persons with an intellectual disability (two and one trials respectively, very low certainty evidence). Behavioural problems were slightly decreased by community-based specialist behavioural therapy (one trial, low certainty evidence). Increasing the frequency and intensity of service delivery probably makes little or no difference to care giver burden (MD 0.03, 95% CI -3.48 to 3.54, two trials, moderate certainty evidence). It is uncertain whether outreach treatment makes any difference for care giver burden (one trial, very low certainty evidence). There was very limited evidence regarding costs, with low to very low certainty evidence for the different interventions. AUTHORS' CONCLUSIONS There is very limited evidence on the organisation of healthcare services for persons with an intellectual disability. There are currently no well-designed studies focusing on organising the health services of persons with an intellectual disability and concurrent physical problems. There are very few studies of organisational interventions targeting mental health needs and the results of those that were found need corroboration. There is an urgent need for high-quality health services research to identify optimal health services for persons with an intellectual disability and concurrent physical problem.
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Affiliation(s)
- Robert Balogh
- University of Ontario Institute of TechnologyFaculty of Health Sciences2000 Simcoe Street NorthOshawaONCanadaL1H 7K4
| | - Carly A McMorris
- Cumming School of Medicine, University of CalgaryDepartment of Pediatrics3820 24th AveCalgaryABCanadaT3B 2X9
| | - Yona Lunsky
- Centre for Addiction and Mental Health, University of TorontoDepartment of PsychiatryTorontoONCanada
| | | | | | - Angela Colantonio
- University of TorontoRehabilitation Sciences Institute500 University Avenue, Suite 160TorontoONCanadaM5G 1V7
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Shooshtari S, Brownell M, Mills RSL, Dik N, Yu DCT, Chateau D, Burchill CA, Wetzel M. Comparing Health Status, Health Trajectories and Use of Health and Social Services between Children with and without Developmental Disabilities: A Population-based Longitudinal Study in Manitoba. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:584-601. [DOI: 10.1111/jar.12253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Shahin Shooshtari
- Department of Community Health Sciences; College of Medicine; University of Manitoba; Winnipeg MB Canada
- St. Amant Research Centre; Winnipeg MB Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy; Department of Community Health Sciences; College of Medicine; University of Manitoba; Winnipeg MB Canada
| | - Rosemary S. L. Mills
- Department of Community Health Sciences; College of Medicine; University of Manitoba; Winnipeg MB Canada
| | - Natalia Dik
- Manitoba Centre for Health Policy; Department of Community Health Sciences; College of Medicine; University of Manitoba; Winnipeg MB Canada
| | - Dickie C. T. Yu
- Department of Psychology; Faculty of Arts; University of Manitoba; Winnipeg MB Canada
| | - Dan Chateau
- Manitoba Centre for Health Policy; Department of Community Health Sciences; College of Medicine; University of Manitoba; Winnipeg MB Canada
| | - Charles A. Burchill
- Manitoba Centre for Health Policy; Department of Community Health Sciences; College of Medicine; University of Manitoba; Winnipeg MB Canada
| | - Monika Wetzel
- Department of Family Social Sciences; Faculty of Human Ecology; University of Manitoba; Winnipeg MB Canada
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9
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Chinn D. Review of Interventions to Enhance the Health Communication of People With Intellectual Disabilities: A Communicative Health Literacy Perspective. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:345-359. [PMID: 26887631 DOI: 10.1111/jar.12246] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Communicative health literacy is a term relating to the range of competencies and capabilities patients bring to the task of seeking information about their health and sharing it with others. This exchange can be problematic for people with intellectual disabilities. The aim of this review was to synthesize findings from interventions designed to improve health communication for people with intellectual disabilities. MATERIALS AND METHOD Available evidence was systematically reviewed, and findings from 14 articles were synthesized in a narrative review. RESULTS AND CONCLUSIONS Interventions addressed communicative aspects of health consultations, taking into account emotional factors and social context. Questions remain about how such interventions might impact on real-life health consultations and how issues of power might be resolved.
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Affiliation(s)
- Deborah Chinn
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
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Nguyen M, Lennox N, Ware R. Hand-held health records for individuals with intellectual disability: a systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:1172-1178. [PMID: 24289283 DOI: 10.1111/jir.12104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/05/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Hand-held health records (HHHRs) aim to empower individuals with intellectual disability (ID) and improve the communication between all those involved in their health care. HHHRs can be used to identify additional health needs and contribute to improved treatment for individuals with ID. This review summarises evidence concerning the use of HHHRs with individuals with ID. METHODS Systematic searching of electronic databases and email contact with established researchers in the field were used to identify relevant articles related to the use of HHHRs among individuals with ID. RESULTS Seven articles were identified and included for review. Studies involved the development, evaluation, acceptability and facilitators and barriers of implementation of HHHRs. HHHRs did not lead to improved short-term healthcare activity, but did lead to more discussion about health problems, increased health-related knowledge and awareness of personal health issues. CONCLUSIONS HHHRs are well accepted among users with ID. However, no short-term benefits were found and future research needs to examine the long-term effects of HHHRs.
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Affiliation(s)
- M Nguyen
- Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Mater Hospital, South Brisbane, Queensland, Australia
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Robertson J, Hatton C, Emerson E, Baines S. The impact of health checks for people with intellectual disabilities: an updated systematic review of evidence. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2450-2462. [PMID: 24984052 DOI: 10.1016/j.ridd.2014.06.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/04/2014] [Accepted: 06/06/2014] [Indexed: 06/03/2023]
Abstract
Health checks for people with intellectual disabilities have been recommended as one component of international health policy responses to the poorer health of people with intellectual disabilities. This review updates a previously published review summarising evidence on the impact of health checks on the health and well-being of people with intellectual disabilities. Electronic literature searches and email contacts were used to identify literature relevant to the impact of health checks for people with intellectual disabilities published from 1989 to 2013. Forty-eight publications were identified, of which eight articles and two reports were newly identified and not included in the previous review. These involved checking the health of people with intellectual disabilities from a range of countries including a full range of people with intellectual disabilities. Health checks consistently led to detection of unmet health needs and targeted actions to address health needs. Health checks also had the potential to increase knowledge of the health needs of people with intellectual disabilities amongst health professionals and support staff, and to identify gaps in health services. Health checks are effective in identifying previously unrecognised health needs, including life threatening conditions. Future research should consider strategies for optimising the cost effectiveness or efficiency of health checks.
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Affiliation(s)
- Janet Robertson
- Centre for Disability Research, Division of Health Research, School of Health and Medicine, Lancaster University, Lancaster LA1 4YT, United Kingdom.
| | - Chris Hatton
- Centre for Disability Research, Division of Health Research, School of Health and Medicine, Lancaster University, Lancaster LA1 4YT, United Kingdom
| | - Eric Emerson
- Centre for Disability Research, Division of Health Research, School of Health and Medicine, Lancaster University, Lancaster LA1 4YT, United Kingdom; Centre for Disability Research and Policy, University of Sydney, Australia
| | - Susannah Baines
- Centre for Disability Research, Division of Health Research, School of Health and Medicine, Lancaster University, Lancaster LA1 4YT, United Kingdom
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12
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Hithersay R, Strydom A, Moulster G, Buszewicz M. Carer-led health interventions to monitor, promote and improve the health of adults with intellectual disabilities in the community: a systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:887-907. [PMID: 24495402 DOI: 10.1016/j.ridd.2014.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 01/06/2014] [Accepted: 01/06/2014] [Indexed: 06/03/2023]
Abstract
Using carers to help assess, monitor, or promote health in people with intellectual disabilities (ID) may be one way of improving health outcomes in a population that experiences significant health inequalities. This paper provides a review of carer-led health interventions in various populations and healthcare settings, in order to investigate potential roles for carers in ID health care. We used rapid review methodology, using the Scopus database, citation tracking and input from ID healthcare professionals to identify relevant research. 24 studies were included in the final review. For people with ID, the only existing interventions found were carer-completed health diaries which, while being well received, failed to improve health outcomes. Studies in non-ID populations show that carers can successfully deliver screening procedures, health promotion interventions and interventions to improve coping skills, pain management and cognitive functioning. While such examples provide a useful starting point for the development of future carer-led health interventions for people with ID, the paucity of research in this area means that the most appropriate means of engaging carers in a way that will reliably impact on health outcomes in this population remains, as yet, unknown.
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Affiliation(s)
- Rosalyn Hithersay
- Research Department of Mental Health Sciences, Charles Bell House, 2nd Floor, 67-73 Riding House Street, London W1W 7EJ, United Kingdom.
| | - André Strydom
- Research Department of Mental Health Sciences, Charles Bell House, 2nd Floor, 67-73 Riding House Street, London W1W 7EJ, United Kingdom
| | - Gwen Moulster
- Haringey Learning Disabilities Partnership, Cumberland House, Cumberland Road, Wood Green N22 7SJ, United Kingdom
| | - Marta Buszewicz
- Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London NW3 2PF, United Kingdom
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Lennox N, Ware R, Carrington S, O'Callaghan M, Williams G, McPherson L, Bain C. Ask: a health advocacy program for adolescents with an intellectual disability: a cluster randomised controlled trial. BMC Public Health 2012; 12:750. [PMID: 22958354 PMCID: PMC3560226 DOI: 10.1186/1471-2458-12-750] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/04/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents with intellectual disability often have poor health and healthcare. This is partly as a consequence of poor communication and recall difficulties, and the possible loss of specialised paediatric services. METHODS/DESIGN A cluster randomised trial was conducted with adolescents with intellectual disability to investigate a health intervention package to enhance interactions among adolescents with intellectual disability, their parents/carers, and general practitioners (GPs). The trial took place in Queensland, Australia, between February 2007 and September 2010. The intervention package was designed to improve communication with health professionals and families' organisation of health information, and to increase clinical activities beneficial to improved health outcomes. It consisted of the Comprehensive Health Assessment Program (CHAP), a one-off health check, and the Ask Health Diary, designed for on-going use. Participants were drawn from Special Education Schools and Special Education Units. The education component of the intervention was delivered as part of the school curriculum. Educators were surveyed at baseline and followed-up four months later. Carers were surveyed at baseline and after 26 months. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. Qualitative interviews of educators occurred after completion of the educational component of the intervention and with adolescents and carers after the CHAP. DISCUSSION Adolescents with intellectual disability have difficulty obtaining many health services and often find it difficult to become empowered to improve and protect their health. The health intervention package proposed may aid them by augmenting communication, improving documentation of health encounters, and improving access to, and quality of, GP care. Recruitment strategies to consider for future studies in this population include ensuring potential participants can identify themselves with the individuals used in promotional study material, making direct contact with their families at the start of the study, and closely monitoring the implementation of the educational intervention. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT00519311.
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Affiliation(s)
- Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Mater Hospital, Raymond Terrace, South Brisbane, Qld 4101, Australia.
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Robertson J, Roberts H, Emerson E, Turner S, Greig R. The impact of health checks for people with intellectual disabilities: a systematic review of evidence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:1009-1019. [PMID: 21726316 DOI: 10.1111/j.1365-2788.2011.01436.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Health checks for people with intellectual disabilities (ID) have been recommended as one component of health policy responses to the poorer health of people with ID. This review summarises evidence on the impact of health checks on the health and well-being of people with ID. METHODS Electronic literature searches and email contacts were used to identify literature relevant to the impact of health checks for people with ID. RESULTS A total of 38 publications were identified. These involved checking the health of over 5000 people with ID from a range of countries including a full range of people with ID. Health checks consistently led to detection of unmet health needs and targeted actions to address health needs. CONCLUSIONS Health checks are effective in identifying previously unrecognised health needs, including life-threatening conditions. Future research should consider strategies for optimising the cost-effectiveness or efficiency of health checks.
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Affiliation(s)
- J Robertson
- Centre for Disability Research, School of Health and Medicine, Lancaster University, Lancaster, UK.
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15
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Tucker M, Taylor Gomez M, Rey-Conde T, Lennox N. Parental Concerns about the Health of Adolescents with Intellectual Disability: A Brief Report. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2011; 2011:164080. [PMID: 22295180 PMCID: PMC3263833 DOI: 10.1155/2011/164080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 04/11/2011] [Indexed: 05/31/2023]
Abstract
Background. Parents of adolescents with intellectual disability are concerned about the future health and well-being needs of their children. Method. Qualitative data was collected as part of a cross-sectional descriptive study and semi-structured interviews were conducted with 32 parents. The results were themed. Results. Most parents discussed areas of their children's health which made them anxious about the future. These concerns were collated into five themes. Conclusion. The health and well-being themes were dependency, general health, challenging behaviours, and increasing support needs.
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Affiliation(s)
- Madonna Tucker
- Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Mater Hospital, South Brisbane, QLD, 4101, Australia
| | - Miriam Taylor Gomez
- Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Mater Hospital, South Brisbane, QLD, 4101, Australia
| | - Therese Rey-Conde
- Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Mater Hospital, South Brisbane, QLD, 4101, Australia
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Mater Hospital, South Brisbane, QLD, 4101, Australia
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16
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Lennox N, Bain C, Rey-Conde T, Taylor M, Boyle FM, Purdie DM, Ware RS. Cluster Randomized-Controlled Trial of Interventions to Improve Health for Adults with Intellectual Disability Who Live in Private Dwellings. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2010. [DOI: 10.1111/j.1468-3148.2009.00533.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Turk V, Burchell S, Burrha S, Corney R, Elliott S, Kerry S, Molloy C, Painter K. An Evaluation of the Implementation of Hand Held Health Records with Adults with Learning Disabilities: A Cluster Randomized Controlled Trial. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2010. [DOI: 10.1111/j.1468-3148.2009.00518.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Taggart L, McMillan R, Lawson A. Staffs' knowledge and perceptions of working with women with intellectual disabilities and mental health problems. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54:90-100. [PMID: 19719516 DOI: 10.1111/j.1365-2788.2009.01211.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM There is a growing evidence of the physical and mental health inequalities in people with intellectual disability (ID) although less has been written concerning the mental health of women with ID (International Association for the Scientific Study of Intellectual Disabilities). This is compared with the substantive literature published within mainstream psychiatry on gender. The aim of this study was to explore a range of health and social care staffs' knowledge and perceptions of caring for women with ID who have mental health problems focusing upon risk and resilient/protective factors. METHOD A qualitative methodology was used. Eight focus groups were conducted with hospital, community and residential staff across one region of the UK. The focus groups were audiotaped and the transcriptions were subjected to a thematic content analysis using Newell & Burnard's framework. FINDINGS Six inter-related risk factors were identified by the participants as potential causes for the women with ID to develop a mental illness and these were: having an ID and being female, unmet expectations, dysfunctional family upbringing, unstable relationships/loss of children, domestic violence and negative life experiences. Few of the participants acknowledged hormonal issues as a risk factor. Resilient/protective factors included being proactive, greater community participation, early recognition and mental health maintenance. CONCLUSION These results are discussed in light of current developments and policy within mainstream psychiatric gender approaches. Greater recognition of a proactive health approach for both staff and women with an ID is recommended.
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Affiliation(s)
- L Taggart
- Institute of Nursing Research, University of Ulster, Northern Ireland.
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